Bio

Clinical Focus


  • Pediatric Neurology
  • Pediatric Stroke

Academic Appointments


Administrative Appointments


  • Director, Stanford Pediatric Stroke Program, Stanford University (2011 - Present)

Honors & Awards


  • Edythe Hembroff-Schleicher Scholarship, University of Victoria (1998)
  • Ethlyn Trapp Memorial Scholarship of Medicine, University of British Columbia (2001)
  • Florence E. Heighway Summer Research Award, University of British Columbia (2002)
  • Prichard Day Award for Excellence in Research, First Prize, Hospital for Sick Children (2008)
  • William Logan Resident Teaching Award, Hospital for Sick Children (2009)
  • Clinical Research Fellowship Salary Award, Thrombosis Interest Group of Canada (2009)
  • National Institute of Neurological Diseases and Stroke (NINDS) Scholarship, NINDS Clinical Trial Methods Course in Neurology, Vail, Colorado (2011)

Professional Education


  • Board Certification: Neurology, Royal College of Physicians and Surgeons of Canada (2009)
  • Medical Education:University of British Columbia (2004) BCCanada
  • Fellowship:University of Toronto (2011) Canada
  • M.S., Stanford University, Masters in Clinical Trial Design and Epidemiology (2013)
  • Fellowship, University of Toronto, Pediatric Stroke (2011)
  • Residency:University of Toronto (2009) Canada

Research & Scholarship

Current Research and Scholarly Interests


My clinical research interests focus on the field of pediatric stroke, and include causes of arteriopathies, novel neuroimaging techniques for the diagnosis of arteriopathies, and maximizing functional outcome after stroke in children. As a member of the International Pediatric Stroke Study, we contribute to an international database of children following stroke, thereby facilitating multi-centered research in this area.

Teaching

2016-17 Courses


Stanford Advisees


Publications

All Publications


  • Vascular Imaging Outcomes of Childhood Primary Angiitis of the Central Nervous System. Pediatric neurology Elbers, J., Armstrong, D., Yau, I., Benseler, S. 2016; 63: 53-59

    Abstract

    Inflammation affecting cerebral blood vessels is a common cause of stroke in children. Arterial abnormalities on vascular imaging are an important risk factor for stroke recurrence. We aimed to describe the vascular imaging outcomes in children with primary angiitis of the central nervous system after 12 months and identify factors associated with vascular progression and stroke recurrence.We retrospectively analyzed clinical and neuroimaging data from the BrainWorks Registry of children with large-vessel primary angiitis of the central nervous system. Neuroimaging was collected at baseline and at least 12-month follow-up, and vascular outcome was categorized as improved, stable, or progressed based on comparison of magnetic resonance angiography. Univariate clinical and neuroimaging predictors were associated with outcome by Fisher exact test.Our study consisted of 27 children; 20 male; median age was 7.92 years (range, two to 15 years). Twelve patients received steroids (44%). Median follow-up time was 16 months (range, 12 to 56 months). Vascular imaging outcome was categorized as improved in 37%, stable in 22%, and progressed in 41% of patients. Discordant progression, defined as progression and improvement occurring simultaneously across multiple vessels, was observed in 26%. Stroke recurred in 15%, occurring exclusively in the group with progression on follow-up imaging (P = 0.02).After 12 months, 40% of children with primary angiitis of the central nervous system demonstrated progression on vascular imaging, without apparent clinical or angiographic predictors. Stroke recurrence was associated with vascular progression. Discordant progression is a newly described angiographic finding. Further studies are necessary to determine if this represents a unique characteristic of inflammatory arteriopathies.

    View details for DOI 10.1016/j.pediatrneurol.2016.06.009

    View details for PubMedID 27469076

  • Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm. Journal of neurointerventional surgery Khatibi, K., Heit, J. J., Telischak, N. A., Elbers, J. M., Do, H. M. 2016; 8 (8)

    Abstract

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

    View details for DOI 10.1136/neurintsurg-2015-011753.rep

    View details for PubMedID 26122324

  • Long-term Outcomes of Pediatric Ischemic Stroke in Adulthood Journal of Child Neurology Elbers J, deVeber G, Pontigon AM & Moharir M.
  • Focal Cerebral Arteriopathy: The Face With Many Names PEDIATRIC NEUROLOGY Tolani, A. T., Yeom, K. W., Elbers, J. 2015; 53 (3): 247-252

    Abstract

    Focal cerebral arteriopathy is a term used to describe unilateral intracranial arteriopathy involving the distal internal carotid artery and proximal segments of the middle and anterior cerebral artery. We describe the disease course of 10 pediatric arterial ischemic stroke patients with focal cerebral arteriopathy from a single quaternary-care center.We retrospectively reviewed pediatric stroke patients with focal cerebral arteriopathy without lenticulostriate collaterals treated at our institution between 2005 and 2014. Angiography was reviewed by a child neurologist and a pediatric neuroradiologist, and chart reviews were performed.Ten individuals with focal cerebral arteriopathy were identified. At the time of stroke presentation, four patients were diagnosed with arterial dissection, two with moyamoya disease, one with embolic occlusion, one with hemorrhagic stroke, and two with arterial dissection or vasculitis. At last follow-up, six patients had a change in diagnosis: four were diagnosed with transient cerebral arteriopathy, two with arterial dissection, and four with moyamoya disease. Four children experienced stroke recurrence. All were administered aspirin, one was administered heparin, two were administered intravenous tissue plasminogen activator, and five underwent surgical revascularization.Among pediatric stroke patients with a similar angiographic appearance, there is variable concordance between diagnosis, prognosis and treatment choice. Improved consensus-based diagnostic criteria and further research is needed to identify disease biomarkers and predictors of arterial progression.

    View details for DOI 10.1016/j.pediatrneurol.2015.05.008

    View details for Web of Science ID 000360951400014

    View details for PubMedID 26122406

  • The Pediatric Stroke Code: Early Management of the Child with Stroke. journal of pediatrics Elbers, J., Wainwright, M. S., Amlie-Lefond, C. 2015; 167 (1): 19-24 e1 4

    View details for DOI 10.1016/j.jpeds.2015.03.051

    View details for PubMedID 25937428

  • Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm. BMJ case reports Khatibi, K., Heit, J. J., Telischak, N. A., Elbers, J. M., Do, H. M. 2015; 2015

    Abstract

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

    View details for DOI 10.1136/bcr-2015-011753

    View details for PubMedID 26109622

  • Emergence of the Primary Pediatric Stroke Center Impact of the Thrombolysis in Pediatric Stroke Trial STROKE Bernard, T. J., Rivkin, M. J., Scholz, K., DeVeber, G., Kirton, A., Gill, J. C., Chan, A. K., Hovinga, C. A., Ichord, R. N., Grotta, J. C., Jordan, L. C., Benedict, S., Friedman, N. R., Dowling, M. M., Elbers, J., Torres, M., Sultan, S., Cummings, D. D., Grabowski, E. F., McMillan, H. J., Beslow, L. A., Amlie-Lefond, C. 2014; 45 (7): 2018-2023
  • Emergence of the primary pediatric stroke center: impact of the thrombolysis in pediatric stroke trial. Stroke; a journal of cerebral circulation Bernard, T. J., Rivkin, M. J., Scholz, K., DeVeber, G., Kirton, A., Gill, J. C., Chan, A. K., Hovinga, C. A., Ichord, R. N., Grotta, J. C., Jordan, L. C., Benedict, S., Friedman, N. R., Dowling, M. M., Elbers, J., Torres, M., Sultan, S., Cummings, D. D., Grabowski, E. F., McMillan, H. J., Beslow, L. A., Amlie-Lefond, C. 2014; 45 (7): 2018-2023

    Abstract

    In adult stroke, the advent of thrombolytic therapy led to the development of primary stroke centers capable to diagnose and treat patients with acute stroke rapidly. We describe the development of primary pediatric stroke centers through preparation of participating centers in the Thrombolysis in Pediatric Stroke (TIPS) trial.We collected data from the 17 enrolling TIPS centers regarding the process of becoming an acute pediatric stroke center with capability to diagnose, evaluate, and treat pediatric stroke rapidly, including use of thrombolytic therapy.Before 2004, <25% of TIPS sites had continuous 24-hour availability of acute stroke teams, MRI capability, or stroke order sets, despite significant pediatric stroke expertise. After TIPS preparation, >80% of sites now have these systems in place, and all sites reported increased readiness to treat a child with acute stroke. Use of a 1- to 10-Likert scale on which 10 represented complete readiness, median center readiness increased from 6.2 before site preparation to 8.7 at the time of site activation (P?0.001).Before preparing for TIPS, centers interested in pediatric stroke had not developed systematic strategies to diagnose and treat acute pediatric stroke. TIPS trial preparation has resulted in establishment of pediatric acute stroke centers with clinical and system preparedness for evaluation and care of children with acute stroke, including use of a standardized protocol for evaluation and treatment of acute arterial stroke in children that includes use of intravenous tissue-type plasminogen activator.http://www.clinicaltrials.gov. Unique identifier: NCT01591096.

    View details for DOI 10.1161/STROKEAHA.114.004919

    View details for PubMedID 24916908

  • Long-Term Outcomes of Pediatric Ischemic Stroke in Adulthood JOURNAL OF CHILD NEUROLOGY Elbers, J., DeVeber, G., Pontigon, A., Moharir, M. 2014; 29 (6): 782-788
  • Long-term outcomes of pediatric ischemic stroke in adulthood. Journal of child neurology Elbers, J., DeVeber, G., Pontigon, A., Moharir, M. 2014; 29 (6): 782-788

    Abstract

    This population-based study assesses the long-term impact of childhood stroke on function and independence in young adults. We undertook a cross-sectional outcome study of patients with arterial ischemic stroke and cerebral sinovenous thrombosis, beyond 18 years of age. We studied 26 patients; 21 arterial stroke, 5 cerebral sinovenous thrombosis, with 16 females. Mean age at assessment was 21.5 years, and mean follow-up time was 10.8 years. According to the modified Rankin Scale, final outcomes were 37% normal, 42% mild, 8% moderate, and 15% severe deficits. Risk factors for abnormal functional outcome included arterial ischemic stroke, presence of arteriopathy, and 1-year poststroke Pediatric Stroke Outcome Measure score ? 2 (P < .05). Most (77-84%) were independent in driving, relationships, and employment. Functional status at 1 year poststroke strongly predicts long-term outcome. Mental illness in one-quarter of young adults surviving childhood stroke represents an important direction for research.

    View details for DOI 10.1177/0883073813484358

    View details for PubMedID 23589374

  • Placental Pathology and Neonatal Stroke. Pediatrics Elbers J, Viero S, MacGregor D, deVeber G, & Moore AM 2011; 127 (3): 722-9
  • Brain biopsy characteristics in children with small vessel central nervous system vasculitis Annals of Neurology Elbers J, Halliday W, Hawkins C, Hutchinson C, & Benseler SM 2010; 68 (5): 602-610
  • Navigating an International Research Elective in a Resource-Poor Setting Canadian Journal of Neurological Sciences Elbers J 2010; 37 (6): 909-911
  • . Treatment of small vessel primary CNS vasculitis in children: An open-label cohort study. Lancet Neurology Hutchinson C, Elbers J, Halliday W, Branson H, Laughlin S, Armstrong D, Hawkins C 2010; 9 (11): 1078-1084
  • The ages and stages questionnaires: Feasibility of use as a screening tool for children in Canada Canadian Journal of Rural Medicine Elbers J, Macnab A, McLeod E, & Gagnon F 2008; 13 (1): 9-14
  • Central nervous system vasculitis in children. Current Opinion in Rheumatology Elbers J, Benseler SM 2008; 20 (1): 47-54
  • A 12-year prospective study of childhood herpes simplex encephalitis: Is there a broader spectrum of disease? Pediatrics Elbers J, Bitnun A, Richardson S, Ford-Jones L, & Tellier R 2007; 119 (2): e399-e407

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